There are a handful of blood work tests that you should be familiar with. We’ll go over them so you have a better understanding of what they are and what you should look for.

NOTE: There is not much clinical testing or data on most of this information. A lot of it is an extrapolation from other studies (keto and LCHF based), and anecdotal information from others who have followed a zero carb diet for long periods of time.

Cholesterol – We used to think that high Total Cholesterol or LDL was bad. According to all the old school information, You would have heart disease and have a severely increased risk for a heart attack with high numbers.

That’s old news. We now know that the more important factors are

  • LDL Particle Number

  • Small LDL Particle Number

  • Having Low Triglycerides and Higher HDL

In fact new studies and meta-analysis are showing with more frequency that higher levels of cholesterol are actually anti-inflammatory AND correlate to a longer life….

Triglyceride:HDL Ratio – This gives you an idea of the size of your LDL particles. Having a lot of LDL Cholesterol isn’t necessarily bad if the particles are large in size. The smaller this ratio, the more you reduce your risk of heart disease. Anything 1 or lower is considered good.


LP-IR Score – This is a rating that takes all the lipid profile information and gives a pretty good idea of insulin sensitivity. It should be used in conjunction with other risk factors and data to help generate a complete risk profile. A score of 45 puts you in the 50th percentile of the population for risk of insulin resistance.


HOMA-IR – This is a rating that tells us how well the body is managing Insulin. It’s not always good enough to look at just Blood Glucose or Insulin by themselves. When we look at how they work together, we can get a better view of any issues with Insulin resistance. Anything under 1 is considered good.


C-Reactive Protein – This measures the amount of stress and inflammation in the body. It can be an indicator of heart disease, arthritis, and other inflammatory conditions. Anything below a 1 is a very low risk and indicates no disease is present.


Apolipoprotein-B  – Apolipoprotein-B (ApoB) is an important component of many lipoproteins that are involved in atherosclerosis and cardiovascular disease. The normal range for apoB is 40-125 mg/dL


Glucose – There are more and more people going zero carb that are seeing their blood glucose rise to higher than we currently think it should be. This is due to “adaptive glucose sparing” where your muscles no longer need as much glucose so there is more left in the bloodstream. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal.


HBA1c – The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. AN HBA1c below 5.7% is considered healthy.


TMAO – There is a compound made in the gut that has been observed to be at high levels in a percent of people that have serious cardiac events. There is no direct link, just an observational study.

Here is Cleveland Heart Labs take on TMAO.


Here is a really good breakdown of the study and what it could really be saying…


There are many documented issues with the study itself and the validity of TMAO being a risk factor is in question. In fact a different, more recent study was released that suggests TMAO is actually beneficial for cardiac health…


For now, consider TMAO to be interesting information. It has yet to be determined if it really matters or not.


Anyone concerned with heart disease or Insulin resistance and having high Cholesterol should look at things in the big picture.

Look at the generally considered risk factors for heart disease from the old school point of view.

Age, Gender, Race, and Family history you can’t do anything about.

  • Smoking

  • Cholesterol

  • Blood Pressure

  • Resting Heart Rate

  • Physical Activity

  • Obesity or Overweight

  • Diabetes

  • Stress and Inflammation

  • Alcohol

  • Diet


Looking at all these factors as a whole, even under the old standards, how are you doing?

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